The present invention concerns noninvasive transdermal systems and methods for analyte extraction from a biological fluid within or beneath the skin, such as interstitial fluid, and detection of the analyte. More particularly, the present invention relates to noninvasive transdermal patches comprised of a wet chemistry component for extraction of the analyte of interest from a biological fluid within or beneath the skin and presentation to a dry chemistry component which interacts with the analyte for indicator molecule formation to confirm detection of the analyte, and methods of use thereof.
The determination of an individual""s physiological status is frequently assisted by chemical analysis for the existence and/or concentration level of an analyte in a body fluid. This practice is common in the diagnosis of diabetes and in the management of this disease. Blood sugar levels can generally fluctuate with the time of day and with the period since the individual""s last consumption of food. Management of diabetes often, thus, requires the frequent sampling and analysis of the diabetic""s blood for determination of its relative glucose level. The management of this disease by the diabetic will typically involve the sampling of his/her own blood, the self-analysis of the sample for its relative glucose content and the administration of insulin, or the ingestion of sugar, depending upon the indicated glucose level.
To determine blood glucose concentrations, blood is presently drawn several times per day by the diabetic. Unfortunately, the current methods of monitoring blood glucose levels has many drawbacks. The current methods generally rely upon finger lancing to monitor blood glucose levels, which is not easy for anyone, especially young children and the elderly. Moreover, because blood is involved, there is always the risk of infection and of transmission of blood borne diseases, such as AIDS. Still further, special procedures and systems for handling and disposing of the blood are required. If the blood glucose concentrations in such individuals are not properly maintained, the individuals become susceptible to numerous physiological problems, such as blindness, circulatory disorders, coronary artery disease, and renal failure. For these reasons, there is a great unmet need for a noninvasive method for monitoring blood glucose levels. A substantial improvement in the quality of life of persons suffering from various maladies, such as diabetes mellitus, could be attained if the concentrations of species in body fluids are noninvasively determined.
There are a number of devices on the market to assist the diabetic in the self-testing of the blood sugar level. One such device, developed by Audiobionics (now Garid, Inc.) and described in U.S. Pat. No. 4,627,445, issued Dec. 9, 1986, involves the use of a fixture containing a multi-layered element for the collection of the whole blood sample, the transport of the sample from the point of application on the element to a porous membrane, and the analysis of the blood sample for its glucose contents by a dry chemistry reagent system which is present within the porous membrane.
Other such devices described in U.S. Pat. Nos. 5,462,064 and 5,443,080 and issued to J. P. D""Angelo et al. involve the use of a multi-part system to collect and analyze constituents of body fluid. In D""Angelo et al., the systems rely upon, among other things, a multilayered gel matrix which includes a separate activation gel layer and a separate collection gel layer disposed below the activation gel layer, an osmotic flow enhancer, such as ethyl ether, to facilitate the collection of an analyte fluid, and a chemistry detection methodology to aid in the visual or electronic determination of an analyte under investigation. Ethyl ether, however, is a known skin irritant which is flammable and explosive.
Another such device described in U.S. Pat. No. 5,203,327 and issued to D. W. Schoendorfer et al., involves a method and apparatus for the non-invasive determination of one or more preselected analytes in perspiration. In D. W. Schoendorfer, et al., the fluid is collected in a dermal concentration patch and concentrated by driving off a portion of the substantial water fraction under the influence of body heat, and the analyte is optimally complexed with an immobilized specific binding partner and an indicium of the presence of the analyte is usually experienced.
Other such devices are described in U.S. Pat. Nos. 4,960,467; 4,909,256; 4,821,733; 4,819,645; and 4,706,676 and issued to Peck. According to these patents, the Peck devices involve a dermal substance collection device (DSCD) which provides for the non-invasive, instantaneous and continuous monitoring of chemical substances which are present in detectable amounts in either or both interstitial fluid or sweat or which are on or in the skin. More particularly, the Peck transdermal substance collection devices are comprised of three essential components: (1) a substance binding reservoir, wettable by (2) a liquid transfer medium which allows for liquid bridge transfer of a soluble substance from the skin surface to the biding reservoir by virtue of its wettability by the liquid, and (3) an occlusive cover.
Exemplary of other systems have been previously proposed to monitor glucose in blood, as is necessary, for example, to control diabetic patients. This is represented, for example, by Kaiser, U.S. Pat. No. 4,169,676, Muller, U.S. Pat. No. 4,427,889, and Dahne et al., European Patent Publication No. 0 160 768, and Bauer et al., Analytica Chimica Acta 197 (1987) pp. 295-301.
In Kaiser, glucose in blood is determined by irradiating a sample of the blood with a carbon dioxide laser source emitting a coherent beam, at a single frequency, in the mid-infrared region. An infrared beam derived from the laser source is coupled to the sample by way of an attenuated total reflectance crystal for the purpose of contacting the blood sample. The apparatus uses double beam instrumentation to examine the difference in absorption at the single frequency in the presence and absence of a sample.
Muller discloses a system for quantifying glucose in blood by irradiating a sample of the blood with energy in a single beam from a laser operating at two frequencies in the mid-infrared region. The infrared radiation is either transmitted directly to the sample or by way of an attenuated total reflectance crystal for in vitro sampling. One frequency that irradiates the sample is in the 10.53-10.6 micrometer range, while the other irradiating frequency is in the 9.13-9.17 micrometer range. The radiation at the first frequency establishes a baseline absorption by the sample, while glucose absorption by the sample is determined from the intensity reduction caused by the sample at the second wavelength. The absorption ratio by the sample at the first and second frequencies quantifies the glucose of the sample.
Dahne et al. employ near-infrared spectroscopy for non-invasively transmitting optical energy in the near infrared spectrum through a finger or earlobe of a subject. Also discussed is the use of near-infrared energy diffusely reflected from deep within the tissue. Responses are derived at two different wavelengths to quantify glucose in the subject. One of the wavelengths is used to determine background absorption, while the other wavelength is used to determine glucose absorption. The ratio of the derived intensity at the two different wavelengths determines the quantity of glucose in the analyte biological fluid sample.
Bauer et al. disclose monitoring glucose through the use of Fourier-transform infrared spectrometry wherein several absorbance versus wavelength curves are illustrated. A glucose concentration versus absorbance calibration curve, is constructed from several samples having known concentrations, in response to the intensity of the infrared energy absorbed by the samples at one wavelength, indicated as preferably 1035 cmxe2x88x921.
Notwithstanding the above, the most frequently employed systems for determining the concentration of molecular substances in biological fluids have used enzymatic, chemical and/or immunological methods. However, these techniques generally require invasive methods to draw a blood sample from a subject; typically, blood must be drawn several times a day by a finger prick, such as presently employed by a diabetic and externally determining the glucose level, generally by chemical reaction followed by colorimetric comparative testing. For example, in the determination of glucose by diabetics, such invasive techniques must be performed using present technology.
Because the prior art invasive techniques are painful, individuals frequently avoid having blood glucose measured. For diabetics, the failure to measure blood glucose on a prescribed basis can be very dangerous. Also, the invasive techniques, which rely upon lancing blood vessels, create an enhanced risk for disease transmission and infection.
Thus, there remains a need in many diverse applications for a system for the noninvasive, painless determination of a preselected analyte in a body fluid, such as interstitial fluid, which can be utilized to detect the presence of the preselected analyte. Clearly, in the case of diabetics, it would be highly desirable to provide a less invasive system for analyzing glucose concentrations in the control of diabetes mellitus. The system should be low-cost and suitable for convenient use by non-medical personnel.
In brief, the present invention overcomes certain of the above-mentioned drawbacks and shortcomings through the discovery of a novel transdermal system for detecting an analyte of interest in a biological fluid and methods concerning same, without resort to prior standard invasive, painful techniques. In accordance with the present invention, the novel noninvasive transdermal systems provide for sample collection and detection in the form of a simple, easy-to-use, integrated system which is low-cost and suitable for convenient use by non-medical personnel. Moreover, because the novel transdermal systems of the present invention are noninvasive and painless, as compared to the invasive techniques generally utilized heretofore, e.g, a finger prick or finger lance, individual compliance should be enhanced, and the risk of disease transmission and infection should be reduced.
With the foregoing in mind and other objects in view, there is provided, in accordance with the present invention, a noninvasive transdermal system for collecting and detecting an analyte of interest in a biological fluid within or underneath the skin. Generally speaking, the noninvasive transdermal systems of this invention are comprised of two essential components (1) a dry chemistry component; and (2) a wet chemistry component. The dry chemistry component comprises a super sensitive or conditioned membrane containing a compliment of chemical reagents which are specific for reacting with one or more analytes of interest. The interaction of the analyte(s) and such chemical reagents is manifest by the release or formation of indicator molecules, e.g., color change, which is indicative of the presence of the analyte(s) in the biological fluid. The surface of the super sensitive or conditioned membrane, which is receptive of and exposed to the analyte of interest, is relatively dense, thereby being generally free of cells, particles and/or other micromolecules which can potentially interfere with reaction of the analyte and the chemical reagents and/or the detection of a reporter molecule. In contrast, the opposing surface of the super sensitive or conditioned membrane is substantially less dense (more porous), thereby allowing for infusion of the reagent system during manufacture, and the formation, diffusion and visualization of reporter or indicator molecules, which are indicative of the presence of the analyte of interest and its level of concentration in the body fluid. The super sensitive or conditioned membrane of the present invention have the unique ability to detect analytes in very small sample volumes, e.g., about 25 mcl, in very small concentrations which are at least as low as about 20 mcg/dl or 1 mcg/5 ml or 0.005 mcg/25 mcl.
The wet chemistry component of the present invention comprises a generally liquid transfer medium which allows for liquid bridge transfer or extraction of an analyte of interest from the biological fluid within or underneath the skin to the super sensitive or conditioned membrane for reaction with the reagents to release or form the reporter or indicator molecule, which is indicative of the presence of the analyte in the biological fluid.
More specifically, and in accordance with the present invention, the compliment of reagents, with which the membrane is conditioned, includes a chemical reactant and a color developer specifically provided for an analyte of interest. Also in accordance with the present invention, the liquid transfer medium is in the form of a gel layer or gel matrix which permits for liquid transfer or extraction of the soluble analyte under investigation from the biological fluid within or underneath the skin to the site of reaction at the super sensitive or conditioned membrane. Preferably, the gel layer is a hydrophobic gel which is inert, nonflammable and nonirritating to the skin. An especially preferred hydrophobic gel in accordance with the present invention is a gel formulated with carboxy polymethylene, marketed or sold under the brand name Carbopol(copyright), and deionized water (18 meg ohm) in a concentration of from about 0.5% to about 2.0%, and preferably in a concentration of about 1%.
In accordance with a further feature of the present invention, the gel includes a permeation skin enhancer selected for the analyte to be detected for enhancing the liquid bridge transfer or extraction of the analyte from the biological fluid within or underneath the skin to the super sensitive or conditioned membrane for reaction and detection. Preferred skin permeation enhancers contemplated by the present invention are those which are nonflammable, nonexplosive and nonirritating to the skin, and which do not interfere with the analyte under investigation, its transfer to the super sensitive or conditioned membrane and its interaction with the chemical reagents. In accordance with the present invention, a preferred skin permeation enhancer is propylene glycol elegantly admixed in the gel in a concentration of from about 5% to about 20%, and especially admixed in the gel in a concentration of about 10%. Thus, an especially preferred gel in accordance with the present invention comprises about 1% carboxy polymethylene, e.g., Carbopol(copyright), and about 10% propylene glycol in deionized water (18 meg ohm).
Alternatively, and also in accordance with the present invention, a skin permeation enhancer may be first directly applied to the targeted skin area to which the transfer medium or gel is applied. While the present invention contemplates the use of a permeation enhancer separate from or in addition to the transfer medium gel, it has been surprisingly discovered that, when a skin permeation enhancer is incorporated into the transfer medium or gel, it is not necessary to apply a skin permeation enhancer directly to the skin before applying the novel noninvasive transdermal systems of the present invention.
Also in accordance with the present invention, the novel noninvasive transdermal systems can be configured as a component of a noninvasive transdermal patch for collection and detection of an analyte in a biological fluid within or underneath the skin. When configured into a noninvasive transdermal patch, it is contemplated that the dry chemistry component and the wet chemistry component are maintained separately prior to use and that, upon use, the super conditioned membrane and the transfer medium shall be the exclusive means of access of the analyte under investigation to the chemical reagents infused onto and/or within the membrane.
In a preferred embodiment in accordance with the present invention, the body fluid from which an analyte may be transdermally extracted is interstitial fluid.
In yet a further feature of the present invention, an electronic interpretation component may be utilized for detecting the reporter or indicator molecules, e.g., color change, generated from the presence of the analyte. in the biological fluid and its reaction with the chemical reagents. The electronic interpretation components should include a light source for illuminating the indicator molecule, a photosensor sensing a reflecting intensity from the indicator molecules and a system for interpreting the measured reflectance intensity and providing information regarding a result of the interpretations.
It should nevertheless be understood that, while any commercial reflectometer capable of reading a color change in a wavelength range of, for example, about 500 nm to about 930 nm at an angle of reflection in the range of about 30xc2x0 to about 90xc2x0 with a voltage of from about 200 to about 1 with a sensitivity of about xc2x10.1 mV, may be used in accordance with the novel noninvasive transdermal systems of the present invention, the reading head of such reflectometers should preferably be configured so as to interface precisely with the recess or through aperture leading to the dry chemistry component of the novel noninvasive transdermal systems. Preferably, the reading head of a reflectometer should have a matching sensor and LED which can read reflectance from color in a wavelength range of from about 650 nm to about 670 nm at an angle of reflectance in the range of about 35xc2x0 to about 45xc2x0 with such sensitivity. FIG. 9 depicts an exemplary reflectometer in accordance with the present invention having a reading head which is configured for precise interface with a recess or through aperture that leads to the dry chemistry component or membrane. The reflectometer depicted in FIG. 9 further includes a visual display for communicating the results detected by the reflectometer. FIG. 10 illustrates a cross section of a reflectometer depicted in FIG. 9 for interfacing with a transdermal patch of the present invention at a 40xc2x0 angle of reflectance for reading color intensity for analyte detection.
With the above-listed objects in view, there is provided, in accordance with the present invention, a collection and indication apparatus for biological fluid constituent analysis, which comprises a collector component for noninvasively and transdermally collecting a body fluid analyte from an individual or subject in the form of a dry chemistry component including a compliment of chemical reagents for reacting with the analyte for indicating its presence and a wet chemistry component for extracting and transferring the analyte from the body fluid within or underneath the skin to the chemical reagents; and a configuration specifically designed for keeping the dry chemistry component and the wet chemistry component intact and separate from one another during non-use, but which allows them to intimately engage one another during testing, so that the dry chemistry component is continuously an d uniformly wetted during testing by the wet chemistry component and the analyte under investigation can be extracted and transferred from the biological fluid within or underneath the skin to the super sensitive or concentrated membrane for interaction with the chemical reagents to generate the reporter or indicator molecules, e.g., color change, to confirm analyte presence. Preferably, the body fluid is interstitial fluid from which the analyte is transdermally and noninvasively extracted and collected.
In other words, the novel noninvasive, transdermal systems of the present invention include three major operational components. The first is the wet chemistry component which functions as the liquid bridge for transferring the analyte of interest from the biological fluid within or underneath the skin to the dry chemistry component, the second component is the dry chemistry component infused with a chemical reaction system specifically for interacting with the analyte of interest to detect its presence, and the third component is a support or housing for the systems which are configured to ensure that the wet and dry chemistry components remain separate during nonuse, but are in direct and continuous contact when the systems are in use and which enables the individual users to physically hold the systems and review the generated data in a rapid and meaningful way. In addition, the novel noninvasive transdermal systems of the present invention contemplate the use of a permeation skin enhancer admixed into the wet chemistry component and/or at the targeted skin areas prior to application of the novel noninvasive transdermal systems to such skin areas. Still further, the novel noninvasive transdermal systems of the present invention contemplate an electronic interpretation component especially configured for precise interfacing with the dry chemistry component, so that the reading head can read changes in color intensity in a preferred wavelength range of about 650 nm +10 nm at an angle of reflectance of about 40xc2x0 with a sensitivity precision of about xc2x10.1 mV. In other words, the electronic interpretation component of the system is configured so as to read the patch component in the event of a visual impairment, or if a more precise numerical value is required, it will give a report in that format.
A novel method of combining test chemistries known to those in the healing arts with the interstitial fluid collection medium in such a manner as to cause to be noninvasively and transdermally extracted from or through the skin, a quantity of analyte of interest sufficient for the chemical test to proceed and then to have the ability to read and record the results in a very short period of time, e.g., a few minutes, is described. This is one of the major objects of this invention.
In a preferred embodiment, the present invention contemplates small disposable transdermal patches for use with a reflectometer to detect an analyte such as glucose. In accordance with the present invention, the small disposable transdermal patches measure blood glucose levels noninvasively. In actuality, the small disposable transdermal patches of the present invention have the unique ability to detect the levels of glucose in interstitial fluid which directly correlate to those levels in the blood. Briefly, and not to be limited, the process is believed to occur as follows. A small disposable transdermal patch of the present invention, which is strategically placed on the targeted skin area, painlessly draws glucose from the interstitial fluid through the skin. The glucose is transported by the skin permeation enhancer combined with a gel capable of transporting glucose through the stratum corneum (upper level of the epidermis). The glucose in the interstitial fluid then undergoes a glucose-specific biochemical reaction at the site of the dry chemistry membrane, the biochemical reaction of which are contained within the dry chemistry membrane in the patch. This biochemical reaction results in a color formation which is then measured by a reflectometer and directly correlated to the blood glucose levels. It is believed that the membrane based technology of the present invention is at least 100, if not 400-500, times more sensitive for detection of very small concentrations of an analyte, e.g., about 20 mcg/dl or 1 mcg/5 ml or 0.005 mcg/25 mcl in a very small volume of fluid, e.g., about 25 mcl, than what is being currently used with finger stick or finger lancing technology. Thus, and in accordance with the present invention, the extraction and detection process only requires a small patch and a small hand held reflectometer. And, because blood is not at all involved, pain and the risk of infection and disease transmission generally associated with glucose monitoring have been eliminated. Moreover, special handling procedures or disposable systems are no longer required.
The noninvasive transdermal systems of the present invention analyze analytes in interstitial fluid rather than blood. Interstitial fluid is the nutrient fluid between the cells within the body tissues. The volume of interstitial fluid in the body is more than three time the blood volumes, and the concentrations of various constituents of the interstitial fluid are generally in equilibrium with the concentrations of those same constituents in blood. In accordance with the present invention, it is believed that small quantities of analyte in the interstitial fluid diffuse into the novel noninvasive transdermal systems with the aid of the gel in combination with a skin permeation enhancer. Once inside the systems of the present invention, the analyte from the interstitial fluid undergoes an enzymatic reaction which leads to the formation of colored indicator material. The color produced is believed to be proportional to the concentration of the analyte in the interstitial fluid, which in turn is proportional to the analyte concentration in the blood. This color is measured by surface reflectance via a fixed-wavelength optical meter, and is then compared to onboard calibration values. The result is typically displayed in units of mg/dl.
An integral component of the invention is the transdermal patch which allows the system to work as a non-invasive skin test for clinical analytes. Additionally, what is shown and described are various configurations, all of which work together as a new and novel system to evaluate chemical analytes from noninvasively and transdermally extracted biological fluids.
Other features which are considered as characteristic for the invention are set forth in the appended claims.
Although the present invention is illustrated and described herein as embodied in an integrated noninvasive and transdermal system for biological fluid constituent analysis, it is nevertheless not intended to be limited to the details shown, since various modifications and structural changes may be made therein without departing from the spirit of the invention and within the scope and range of equivalents of the claims.
The construction of the invention, however, together with additional objects and advantages thereof will be best understood from the following description of specific embodiments when read in connection with the accompanying FIGS. and examples.
The above features and advantages of the present invention will be better understood with reference to the following detailed description and examples. It should also be understood that the particular methods and formulations illustrating the present invention are exemplary only and not to be regarded as limitations of the present invention.